Nabb1:hillbillypharmacist: Nabb1: I don't know, but if the prevailing view in the medical community is that, from a medical standpoint, birth control should be available OTC, why force a woman to get a prescription? If a woman wants to talk to a doctor before taking OTC birth control, then good for her. No one should stop her. But why make her go through that step if it is not medically necessary?

There is not a bright line definition of 'medically necessary'. If a public health good can be accomplished by making it OTC, then it weighs against restricting it to a prescription. ACOG (and myself) think that, at the moment, we would be better served by making it OTC. However, if the public health good can be accomplished without it being OTC by using a single payer or other comprehensive system, then the medical reasons to keep it prescription only should prevail instead.

So, again, you would keep women from getting birth control OTC in order to advance your political agenda for a much larger nationalization of the health care industry.

How about reading what he wrote? I've bolded the important part for you.

Elandriel:Making an untrained woman personally in charge of ingesting medicine that has enormous hormonal change is hilariously irresponsible. People are still so damn hung up on this being about not getting pregnant, instead of the host of other effects BC pills have on a woman from cyst prevention to cycle regulation. Making it OTC divorces the process of consultation and medical expertise from it, and endangers women everywhere.

Buying birth control OTC in no way precludes a woman from consulting a doctor, it just removes that from being a requirement. If a woman is having no issues with an OTC med and wants to handle it herself, what's the problem?

I wonder how many people who want to "legalize drugs" (as I do) here on Fark are on the side of keeping some meds prescription-only. If you're prepared to let people alter their consciousness and potentially destroy their health and lives with one substance, you may as well extend the privilege to all of them.

what_now:I actually disagree. Hormonal birth control should be monitored by a doctor. There can serious emotional and physical side effects from using BC, and a woman should be able to have a doctor prescribe and monitor her use, until they find the correct dosage.

Now, we should have single payer healthcare and BC should be free, but someone needs to prescribe it.

There are serious side effects from a lot of OTC drugs. No one would prevent women from having a doctor monitor her use to find the correct dosage. The real question is can a regular person be tasked to make an appropriate and safe decision for themselves. For every single side effect of birth control, a woman can easily make the appropriate decision with no risk. The vast majority are fine "headache, whoopdy doo." Other times that appropriate decision will be to go see a doctor:

Imagine two women, one bought BC OTC the other was required to get a prescription. Both get abdominal pain. They're in the exact same boat. Whether they got a prescription to start or not, they both will make the choice to see a doctor or not. The prescription didn't help either of them.

SuperTramp:Hey Nabb1, could you hand the microphone to your uterus for a minute?

That's a stupid argument. I'm not planning to have kids, does that make my opinions about education moot? I'm not gay, so my feelings on marriage equality are null & void? I'm not rich, so my views on the top 3 brackets don't matter (actually, there are many people that believe this)? I live in America, so my feelings about her foreign policy don't matter?

// it comes into play when you tell a SPECIFIC person what to do with her uterus// but I'll let you see for yourself how that applies to men and women

what_now:Nabb1: what_now: I actually disagree. Hormonal birth control should be monitored by a doctor. There can serious emotional and physical side effects from using BC, and a woman should be able to have a doctor prescribe and monitor her use, until they find the correct dosage.

The American College of Obstetricians and Gynecologists disagrees. Link

They're making the best of a bad situation. Women without health insurance should still have across to birth control, they say, and under the current situation, they are correct.

Lets solve the underlying problem of women who don't have access to health care.

I gave an uninsured friend some of my left over birth control pills and a few months later she walked into an emergeny room worried she was going to kill herself.

Now, she was in law school at the time...

Step 1: Restrict access to a drug.Step 2: People get it through illegal meansStep 3: Some people experience side effects.

Just for some context - you can buy BC over the counter in Dubai, a country with a legal system based on Sharia law. It's also about a quarter the price as in the US, which should give you an idea how much we're being scammed by Big Pharma.

lennavan:what_now: I actually disagree. Hormonal birth control should be monitored by a doctor. There can serious emotional and physical side effects from using BC, and a woman should be able to have a doctor prescribe and monitor her use, until they find the correct dosage.

Now, we should have single payer healthcare and BC should be free, but someone needs to prescribe it.

There are serious side effects from a lot of OTC drugs. No one would prevent women from having a doctor monitor her use to find the correct dosage. The real question is can a regular person be tasked to make an appropriate and safe decision for themselves. For every single side effect of birth control, a woman can easily make the appropriate decision with no risk. The vast majority are fine "headache, whoopdy doo." Other times that appropriate decision will be to go see a doctor:

Imagine two women, one bought BC OTC the other was required to get a prescription. Both get abdominal pain. They're in the exact same boat. Whether they got a prescription to start or not, they both will make the choice to see a doctor or not. The prescription didn't help either of them.

Now we get into the fun part; would the doctor's visit for what is now an optional medication be covered under insurance? I doubt it. So now we've got women paying full cost out-of-pocket for the medication, and full cost out-of-pocket for a doctor's visit about the medication.

I'm almost starting to think this is a ploy to get people to think that HBC is unsafe.

what_now:I actually disagree. Hormonal birth control should be monitored by a doctor. There can serious emotional and physical side effects from using BC, and a woman should be able to have a doctor prescribe and monitor her use, until they find the correct dosage.

Now, we should have single payer healthcare and BC should be free, but someone needs to prescribe it.

but at least let's give credit where credit is due.

This is a reasonable conservative solution -- instead of trying to deny medication to the public, make them more available even if more available is more costly to low income families and more likely to be misused by the public.

i'd rather that family planning and services to assist people in this endeavor be a public service (mostly free) but at least we are moving this from "you are a slut you pill popping slut" to "i'll never know and never should I care"

Sorry. I proeabably can't comment *too* rationally on this issue-the idea of OTC birth control makes my brain go "BAD IDEA", largely due to having watched my fiance (well, girlfriend at the time) have a stroke due to a generic of Yaz at the age of 23. (And since it wasn't Yaz, but a GENERIC of Yaz, she wasn't really able to get in on the class action about it...)

Yes, she was the one-in-a-million statistic (and was taking it far before I knew her, for health reasons), but it's things like that which make me feel that there should be a doctor involved, if only to make sure people know the risks and can be more closely monitored. However, I recognize this is likely strongly colored by my own personal experiences.

I'd also like to see the other forms of female birth control and hormone regulation be discussed more in the US. The birth control pill isn't the *only* one.

Nabb1:what_now: Nabb1: TheBeastOfYuccaFlats: Nabb1: The objections to this seem more political than scientific, to me, anyway.

Having seen the tribulations of what my various female friends have gone through to find the correct HBC, I'm firmly in the camp of having it be RX only (through PP or some gyn or whatever).

As other said, it should be a no-copay covered medication and we should have single payer anyway, but yeah, I really think that its a complex enough issue with enough patient education and variance needed that a Doc should be involved.

I'm sorry, is there anything that would prohibit a woman from speaking to her doctor about all this without the necessity of needing a prescription for the actual medication?

Yes. If she doesn't have a doctor because she can't afford healh insurance.

And if she can't afford health insurance, then she can't get prescription birth control. Sudafed kills more people than birth control, and that's OTC. Sort of. Stupid tweakers. (Sudafed causes atrial fibrillation in some people.) I'm not going to presume to second guess the American College of Obstetricians and Gynecologists on this. If they think it's safe enough to go forward with it, I say go. I had the same concerns as you until very recently.

qorkfiend:Now we get into the fun part; would the doctor's visit for what is now an optional medication be covered under insurance? I doubt it.

Of course it would. Pap-smears and general check-ups wouldn't suddenly become unnecessary. During your general check-up, you can ask about a whole slew of things including OTC medicines and insurance will still cover it.

I'm honestly surprised to see the ACOG support BC being OTC. I always viewed it as they hold BC over your head because otherwise you wouldn't go in for annual exams. We'd probably have a much healthier population if we required regular check-ups before letting you have painkillers like aspirin/ibuprofen too.

lennavan:qorkfiend: Now we get into the fun part; would the doctor's visit for what is now an optional medication be covered under insurance? I doubt it.

Of course it would. Pap-smears and general check-ups wouldn't suddenly become unnecessary. During your general check-up, you can ask about a whole slew of things including OTC medicines and insurance will still cover it.

I'm honestly surprised to see the ACOG support BC being OTC. I always viewed it as they hold BC over your head because otherwise you wouldn't go in for annual exams. We'd probably have a much healthier population if we required regular check-ups before letting you have painkillers like aspirin/ibuprofen too.

Or, you know, women can actually have very bad and dramatic reactions to hormones and it's a good idea to have a doctor make sure you don't end up sicker than a dog.

But yeah. It's about money.

/I'm sure a lot of doctors are scamming people--hell, my doctor outright told me at one point that prescribing medications for ear infections is basically just so people feel like they're getting their money's worth--but this is not one of those times. Hormones are really, really bad things to fark up.

Corvus:As a guy. you can buy condoms over the counter, you can buy them in bathrooms, you can get them free from lots of places.

But when it's women contraception it's OMG!!! We have to make sure people can't just buy them and we have to make sure religious groups aren't offended.

It's double standard BS.

You can buy condoms OTC precisely because they don't have anywhere near the potential long-term serious consequences of OBC. I can't believe you don't see this. As someone said earlier, the solution is to make OBC cheap/free and easy to get, not make it OTC. Guess who already does that? Planned Parenthood. Every day.

SuperTramp:SuperTramp: Hey Nabb1, could you hand the microphone to your uterus for a minute?

Dr Dreidel: That's a stupid argument.

Did I ask you? I asked Nabb1 because he seems REALLY invested in this issue.

He's really invested because it's a perfect solution for conservatives. They get to make it look like they're pro-women (by increasing access to contraceptives and simultaneously exposing women as a whole to greater risk), it pushes government out of the way to allow every woman to be her own doctor (as wonderful and magical as that sounds), and it accomplishes their number one policy directive: don't do anything to piss off the religious assholes that make up their base. They get to polish their image while continuing to cater to the most backward and dangerous parts of the electorate. It would be smart if it wasn't so brazenly transparent.

BCP are hormones; they shouldn't be dispensed without care to the woman's health. The annual visit to the cooter dr. is to ensure nothing is amiss down there. BCP being prescription isn't some rightwing nutjob conspiracy to make access to BCP harder; it is a sound medical practice.

HBC should be prescription only. Too many idjits take OTC pills as though they were nothing; HBC has significant issues, ranging from DVT dangers to emotional issues.

Also - from the perspective of a transwoman, far too many people can't tell the difference between progesterone and estrogen. And progesterone is f*cking dangerous for those that have no natural source of it.

He's really invested because it's a perfect solution for conservatives. They get to make it look like they're pro-women (by increasing access to contraceptives and simultaneously exposing women as a whole to greater risk), it pushes government out of the way to allow every woman to be her own doctor (as wonderful and magical as that sounds), and it accomplishes their number one policy directive: don't do anything to piss off the religious assholes that make up their base. They get to polish their image while continuing to cater to the most backward and dangerous parts of the electorate. It would be smart if it wasn't so brazenly transparent.

jjorsett:I wonder how many people who want to "legalize drugs" (as I do) here on Fark are on the side of keeping some meds prescription-only. If you're prepared to let people alter their consciousness and potentially destroy their health and lives with one substance, you may as well extend the privilege to all of them.

No. There are very good reasons to keep some medications prescription only, even if you want recreational drugs to be legal (as I do). We are already seeing issues with bacterial infections developing resistance to antibiotics, creating MRSA, residtant strains of Gonorrhea, etc.

During the 2001-2002 Anthrax scares, every idiot under the sun decided they needed Cipro, just in case Truth or Consequences, NM was going to be terrorized. I don't particularly care if some dude develops a tolerance for meth or adderall as it doesn't really do me any harm. That dude running around spewing a super bug because he takes Zeftera every time he gets the sniffles, or thinks that Cipro will clear up his athlete's foot can cause me harm.

un4gvn666:SuperTramp: SuperTramp: Hey Nabb1, could you hand the microphone to your uterus for a minute?

Dr Dreidel: That's a stupid argument.

Did I ask you? I asked Nabb1 because he seems REALLY invested in this issue.

He's really invested because it's a perfect solution for conservatives. They get to make it look like they're pro-women (by increasing access to contraceptives and simultaneously exposing women as a whole to greater risk), it pushes government out of the way to allow every woman to be her own doctor (as wonderful and magical as that sounds), and it accomplishes their number one policy directive: don't do anything to piss off the religious assholes that make up their base. They get to polish their image while continuing to cater to the most backward and dangerous parts of the electorate. It would be smart if it wasn't so brazenly transparent.

It's still pretty smart, as the people he's talking to don't care about the transparency. Jindal's position is the perfect line to walk on the moderate right side of the issue; personal responsibility, no government interference with doctors, no interference from pharmacists, access to birth control, and as you've pointed out, completely avoids the religious aspect of the debate. All of the downsides - cost and potential health risks - are already secondary in Republican thinking.